Organization
A CHANCE FOR CHANGE, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RODNISHA SADE CANNON (CHIEF EXECUTIVE OFFICER)
(704) 923-9701
Entity
Organization
Contact information
Practice address
334 S VINE ST, GASTONIA, NC 28052-3575
(704) 923-9701
Mailing address
334 S VINE STREET, GASTONIA, NC 28052-4052
(704) 923-9701
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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